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Neuropathic pain in children: Steps towards improved recognition and management

Suellen M Walker1

  • 1Developmental Neurosciences Program, UCL Great Ormond St Institute of Child Health, London, United Kingdom; Department of Anaesthesia and Pain Medicine, Great Ormond St Hospital NHS Foundation Trust, London, United Kingdom.

Ebiomedicine
|November 28, 2020
PubMed

Insights

Diagnosing neuropathic pain in children is challenging due to age-related factors and the need for validated tools. Advanced methods like sensory testing, brain imaging, and genetic analysis can improve individualized treatment and clinical trials for pediatric neuropathic pain.

Area of Science:

  • Pediatric neurology
  • Pain medicine
  • Neuroscience

Background:

  • Neuropathic pain in children presents significant challenges in recognition, management, and leads to substantial pain-related disability.
  • Current diagnostic methods, including clinical history and screening tools, face limitations in young children and require further validation in older age groups.
  • Age- and sex-dependent physiological changes can impact the feasibility and interpretation of confirmatory tests for somatosensory nervous system lesions.

Purpose of the Study:

  • To explore advanced diagnostic and research methodologies for neuropathic pain in children.
  • To identify potential biomarkers and genetic causes of pediatric neuropathic pain.
  • To inform individualized therapy and clinical trial stratification for improved management.

Main Methods:

  • Quantitative sensory testing (QST) to identify mechanism-related sensory profiles.
  • Brain imaging as a potential biomarker for central pain processing alterations.
  • Genetic analysis to uncover known and novel causes of neuropathic pain.
  • Utilizing patient- and parent-reported outcome measures.

Main Results:

  • Quantitative sensory testing can delineate specific sensory profiles related to pain mechanisms.
  • Brain imaging shows potential as a biomarker for altered central pain processing and modulation.
  • Genetic analysis offers insights into the underlying causes of neuropathic pain.
  • Existing outcome measures, alongside new research methodologies, are crucial.

Conclusions:

  • Developing validated, mechanism-based standardized endpoints is essential for advancing the evidence-based management of pediatric neuropathic pain.
  • Individualized therapy and clinical trial stratification can be improved through advanced research methodologies and validated endpoints.
  • Further research into QST, neuroimaging, and genetics will enhance diagnostic accuracy and treatment strategies for children with neuropathic pain.

Keywords:
AdolescentsChildrenChronic painNeuropathic painNeuropathyQuantitative sensory testing

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